Occupational Medicine Department, Urmia University of Medical Sciences, Urmia, Iran.
Int J Occup Med Environ Health. 2012 Sep;25(4):383-91. doi: 10.2478/S13382-012-0051-5. Epub 2012 Sep 29.
This study examined the effect of shift work on developing the metabolic syndrome by comparing groups of exposed and unexposed Iranian drivers.
We considered as night-shift drivers those drivers whose shifts included at least 15 h per week between 9:00 p.m. and 7:00 a.m. Daytime drivers were defined as drivers working regularly without shift work. 3039 shift work drivers were selected. These were matched with non-shift workers. The differences in baseline characteristics and the prevalence of the components of the metabolic syndrome were assessed with Student's t test, and chi-square tests.
We found central adiposity in 52.0% of the shift workers versus 42.6% of the day workers (p < 0.0001). The hypertension component was not significantly related to shift work (p > 0.05); but there were significant differences as regards other components of the metabolic syndrome (p < 0.0001). Among the shift workers, the odds ratios of the increased FBS, low HDL-C, higher TG levels, as well as higher waist circumference were 1.992 (95% CI: 1.697-2.337), 1.973 (95% CI: 1.759-2.213), 1.692 (95% CI: 1.527-1.874), and 1.460 (95% CI: 1.320-1.616), respectively. The metabolic syndrome was more common among the shift workers (OR = 1.495; 95% CI: 1.349-1.657).
In evaluating such results, further consideration is needed to find pathophysiological clarification; in turn, stress linked to shift work must be considered to likely have had a relevant influence on the outcome. In our opinion, shift work acts as an occupational factor for the metabolic syndrome.
本研究通过比较伊朗暴露组和未暴露组司机,探讨轮班工作对代谢综合征的影响。
我们将每周至少工作 15 小时,工作时间在晚上 9 点至早上 7 点的司机定义为夜班司机,而将没有轮班工作的司机定义为白班司机。共选择了 3039 名轮班工作的司机,并与非轮班工人进行匹配。采用学生 t 检验和卡方检验评估两组间基线特征和代谢综合征各组分的差异。
我们发现轮班工作者的中心性肥胖发生率为 52.0%,而白班工作者为 42.6%(p<0.0001)。高血压组分与轮班工作无显著相关性(p>0.05);但其他代谢综合征组分存在显著差异(p<0.0001)。在轮班工作者中,空腹血糖升高、低高密度脂蛋白胆固醇、甘油三酯水平升高和腰围增大的比值比分别为 1.992(95%可信区间:1.697-2.337)、1.973(95%可信区间:1.759-2.213)、1.692(95%可信区间:1.527-1.874)和 1.460(95%可信区间:1.320-1.616)。轮班工作者中代谢综合征更为常见(比值比=1.495;95%可信区间:1.349-1.657)。
在评估这些结果时,需要进一步考虑寻找病理生理学的解释;反过来,轮班工作带来的压力可能对结果产生了相关影响。在我们看来,轮班工作是代谢综合征的一种职业因素。